MATTHEW S ELLISON (NPI# 1578185211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578185211 |
| Entity Type | Individual |
| Full Name | MATTHEW S ELLISON |
| Credential | D.O. |
| Practice Address |
5635 W Fort St Detroit MI 48209-3154 |
| Mailing Address |
1135 W University Dr Ste 225 Rochester MI 48307-1890 |
| Practice Telephone | 3138493920 |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2020-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2799 W Grand Blvd, Detroit, MI 482022608 | 3139162600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393213 | Matthew T Ellison | Dentist | Dental Clinic 2, 3740 South 14th St., Joint Base Lewis-mcchord, WA 98433 | 2020-07-21 |
| 1487065918 | Matthew Patrick Ellison | Dentist | 150 West Crescent Square Dr., Graham, NC 27253 | 2014-05-19 |
| 1760689012 | Matthew Blair Ellison | General Practice | 1 Medical Center Drive, Morgantown, WV 26506 | 2007-06-29 |
| 1598865438 | Matthew D Ellison | Otolaryngology | 1781 Tate Blvd Se, Suite 201, Hickory, NC 28602-4251 | 2006-09-22 |
| Street Address |
5635 W FORT ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48209-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992795165 | Felix Mario Valbuena Jr. | Family Medicine | 5635 W Fort St, Detroit, MI 48209-3154 | 2005-10-27 |
| 1336746270 | Holly Ferguson | Student in an Organized Health Care Education/Training Program | 5635 W Fort St, Detroit, MI 48209-3154 | 2020-10-05 |
| 1538708276 | Christopher Sanjurjo Montalvo | Student in an Organized Health Care Education/Training Program | 5635 W Fort St, Detroit, MI 48209-3154 | 2019-12-28 |
| 1124667019 | Daniela Lopez | Counselor | 5635 W Fort St, Detroit, MI 48209-3154 | 2019-12-26 |
| 1548733629 | Maryrose Benson | Student in an Organized Health Care Education/Training Program | 5635 W Fort St, Detroit, MI 48209-3154 | 2019-01-10 |
| 1568935633 | Sharon Almonte | Student in an Organized Health Care Education/Training Program | 5635 W Fort St, Detroit, MI 48209-3154 | 2019-01-10 |
| 1962973784 | Luis Felipe Cebas | Social Worker | 5635 W Fort St, Detroit, MI 48209-3154 | 2018-12-06 |
| 1932611761 | Sherry Lynn Ismail | Registered Nurse | 5635 W Fort St, Detroit, MI 48209-3154 | 2017-11-02 |
| 1992223507 | Jaribeth Disla | Counselor | 5635 W Fort St, Detroit, MI 48209 | 2017-09-04 |
| 1497271894 | Mirna Robles | Registered Nurse | 5635 W Fort St, Detroit, MI 48209-3154 | 2017-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316501471 | El Valle Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 1940 Campbell, Detroit, MI 48209 | 2019-04-24 |
| 1598211583 | Elizabeth Lopez-riachi | Technician, Other | 1551 Cavaqlry St., Detroit, MI 48209 | 2016-08-30 |
| 1205210333 | Yamirka Torres | Behavioral Analyst | 1551 Cavalry St, Detroit, MI 48209 | 2015-07-18 |
| 1689943359 | Jessica Male | Pharmacist | 6223 W Jefferson Ave, Detroit, MI 48209 | 2011-12-23 |
| 1003070723 | Mark Beard | General Practice | 5700 W Vernor Hwy, Detroit, MI 48209 | 2008-07-11 |
| 1891980330 | Emery K Toth | Dentist | 8028 W Vernor Hwy, Detroit, MI 48209 | 2007-09-07 |
| 1225131881 | Eva A Karmo | Dentist | 4607 W. Vernor Hwy, Detroit, MI 48209 | 2006-09-07 |
| 1023123858 | Wanda E Velez Ruiz | Internal Medicine | 4115 W Vernor, Detroit, MI 48209 | 2006-08-20 |
| 1235142563 | Wendy Yousif Mckay | Family Medicine | 5831 W Vernor, Detroit, MI 48209 | 2006-08-15 |
| 1316950645 | Sahir H Cittan | Family Medicine | 5831 West Vernor, Detroit, MI 48209 | 2006-08-15 |
| Find all providers in zip 48209 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.